1applesFood security has been officially defined as “when all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life” by the World Food Summit of 1996(1). Food insecurity, therefore, is the opposite of this: when someone’s food supply is occasionally or always insufficient, unsafe, or unhealthy, and they are unable to live out a healthy lifestyle as a result. Food insecurity includes disrupted meal intake, decreased food quality, a sense of worry regarding where food will come from, reliance on emergency food sources, or not being able to eat in line with food preferences.
Many, if not all of us, have come into contact with individuals lacking either physical or economic access to nutritious, healthy food. There is really no place we could not see someone who may be classified as food insecure. Food is not a right in the United States, and so as citizens we have come to understand, and adapt to, the hard truth that not everyone has the luxury of nutritious food, let alone food at all. 48.1 million people in the United States are living in food-insecure households, and more than 15 million of those are children(2). In Virginia, despite having one of the lowest rates of childhood food insecurity in the country according to the USDA, the prevalence of food insecurity is still 11.8%, or roughly 913,000 people. Of note, the District of Columbia, a state close to home for many Virginians, has the highest prevalence of childhood food insecurity, coming in at over 31% in 2013(3). Rates of food insecurity are highest among households with children, households with single parents, black, non-Hispanic families, and households living below 185% of the poverty threshold(2).

Peeled peanut andl peanuts in shell, studio shot
So what does food insecurity look like in America? Perhaps families or individuals are food insecure because they do not live near a grocery store, without enough gas money to fill up their car. Maybe they don’t even have a car, and must rely on their feet or public transportation to get to the nearest food outlet. They may not be able to afford as much food as the end of the month approaches if their income and/or government assistance (if applicable) starts to run out before they make it to the next month. If a gas station or convenience store is someone’s most accessible and affordable source of food, they are at the complete disposal of whatever that store may be selling, healthy or unhealthy. Many families do not have control over what is physically or economically available to them, forcing them to make consistently unhealthy and/or undesirable food choices. Household adults will often disrupt their own intake before allowing their child to miss out on meals or go hungry, but sometimes there just isn’t enough to go around, and children suffer alongside their adult family members. At the 2016 VAND annual meeting, Dr. Robert Murray, a professor from the Ohio State University School of Medicine, discussed the importance of adequate nutrition for proper early childhood development. He highlighted the vital role of nutrition in neurological development, adding that prolonged hunger or food insecurity can be a persistent stressor in children. Such prolonged stressors can lead to impaired neurocognitive, social and emotional development, as well as numerous adverse health outcomes later in life(4). Potential long-term health consequences include increased risk of developing type 2 diabetes, obesity, high blood pressure, heart disease, metabolic syndrome, and high blood cholesterol. Adding to chronic physical health problems, food insecurity can also contribute to mental health issues, not limited to depression, anxiety and chronic stress.
Many public federal assistance programs are in place to help those struggling with food insecurity, such as SNAP (Supplemental Nutrition Assistance Program), WIC (Women, Infants and Children), the National School Lunch and Breakfast Programs, and various summer food programs. These programs provide families with supplemental monetary assistance or vouchers to purchase foods in line with government dietary recommendations; however, these benefits are not intended to totally support dietary intakes of participating individuals. Emergency food assistance, such as food banks, pantries and soup kitchens, can be used independent of or in conjunction with federal assistance programs to further help provide adequate food, yet their typical food options are often lacking nutritionally and can further contribute to adverse health outcomes down the road.

So what can we do? It is important for healthcare providers, including dietitians, to stay informed on the prevalence of food insecurity in their area and to consider economic and social barriers that may be present in patients when conducting nutrition educations or providing dietary recommendations. Tailoring recommendations and goals to the individual person and/or family is more likely to make a lasting impact on their health compared to something generalized that may not be feasible for them to put into action. Helping people become familiar with sources of aid in their community could help them live as healthfully as possible, despite maybe not having access to ideal food resources. As health professionals and as a community, we can also advocate for public policy. Dorothy McAuliffe, the First Lady of the Commonwealth of Virginia, has made eliminating childhood hunger and improving everyone’s access to healthy and local food a policy priority. A believer in the importance of early childhood nutrition for long-term academic and social success, Mrs. McAuliffe promotes community efforts which educate families on the value of locally grown food, education, nutrition and overall health and well-being(5). Childhood hunger and community food insecurity are worldwide problems that aren’t going to disappear overnight. Spreading awareness, advocating for public and governmental support, and providing personalized patient care are a few steps in the right direction. I encourage you to show Virginia, the United States, and the world how hungry you are for change – for no child should have to experience hunger.

1.  WHO. Glossary of globalization, trade and health terms: food security. World Health Organization. 2016.
2.  Coleman-Jensen A, Rabbitt M, Gregory C, Singh A. Household food security in the United States in 2014. USDA ERS. 2015.
3.  Gundersen C, Satoh A, Dewey A, Kato M, Engelhard E. Map the meal gap 2015: food insecurity and child food insecurity estimates at the county level. Feeding America. 2015.
4.  Dr. Murray R. PowerPoint Presentation: The learning connection. VAND Annual Meeting Conference. 2016.
5.  Dorothy McAuliffe. Virginia.gov. 2015.


HersheyMonica Hershey is currently a dietetic intern at the University of Virginia Health System in Charlottesville, VA. A Pennsylvania native, Monica earned her undergraduate degree in nutritional sciences at Penn State University with an emphasis in community nutrition and food security. Upon graduation, Monica would like to work as a clinical RD at a large medical facility on the East Coast, with hopes of working as a renal dietitian in the near future. Her personal interests include hiking with friends, recipe-less cooking and exploring all the fun that Charlottesville has to offer!

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